Ch4

Question 1

Explain the important of folate during pregnancy and suggest sources of folate that the women may include in her diet.

Answer 1

• Folate is required for DNA replication and is a component in enzymatic reactions. Inadequate folate is associated with anaemia and reduces foetal growth
• Folate is important in critical periods of growth as low folate can interrupt the formation of the brain and spinal cord causing NTDs.
• Recommended to have 400mcg folic acid supplements.
• Dietary sources of folate include fortified foods and dark green leafy vegetables.

Question 2

Describe the difference between gestational age and menstrual age

Answer 2

• Gestational age = assessment from the date of conception
• Menstrual age = assessment from onset of last menstrual period.

Question 3

Define critical periods during pregnancy and explain its importance in foetal development.

Answer 3

• Critical periods are the time during foetal development when cells, organs, and tissues are formed.
• Most intense in first 2 months after conception.
• It isn’t possible to reverse or correct errors in growth that occurred during a periods critical period.
• Effects that occur in critical period persist throughout life.

Question 4

Two historical examples indicate foetal growth trajectory during early pregnancy.

Answer 4

Dutch winter famine
- Birthweight declines and delivery of low-birthweight infants increases.

Siege of Sarajevo
- A decrease in food availability causes low-birthweight infants.

birthweight didn’t catch up in infants born to women exposed in early pregnancy even if they received food in later pregnancy. This support foetal growth trajectory that what happens in early pregnancy cannot be reversed.

Question 5

Five examples which nutrient requirement during pregnancy change

Answer 5

• Fat: used as energy source and aids in foetal brain and retina development. fatty acid stored depleted due to demand of foetus.
• Calcium: for skeletal mineralisation and maternal bone health. Demand peaks in 3rd trimester when bones are mineralising at rapid rate.
• Iron: iron demand increases as it’s used by foetus and placenta, lost at delivery, and used to increased RBC.
• Iodine: required for thyroid function, energy production, and brain development.
• Sodium: maintains body water balance. requirement increase due to plasma volume expansion.

Question 6

Physiological demand increasing energy requirement in pregnancy

Answer 6

• Energy required increase for protein and fat tissue synthesis and to maintain expanding metabolically active tissues.
• Protein synthesis: in foetal, placenta, uterine and breast tissue
• Fat synthesis: used to build maternal fat stores.
• Increased work of mother cardiovascular, respiratory and renal system is response for increase of energy.

Question 7

4 cases in which multivitamin supplements may benefit pregnant women

Answer 7

• Folate: NTDS in early pregnancy, 400mcg supplements.
• Vitamin D: low in food, difficult in South island, and dark skin from sunlight. vitamin D3 is preferred.
• Iodine: lack in the food supply in NZ.
• Omega 3 fatty acids: depending on food consumption, vegans or vegetarians, stores easily depleted.